We are here to help you understand your health care choices. Your questions are important. This is a good place to start if you want to learn about CCC Plus, health plans, and PCPs.
If you can't find an answer here, call us at 1-844-374-9159 (TTY: 1-800-817-6608).
What is the CCC Plus Program?
Commonwealth Coordinated Care Plus (CCC Plus) is our new Medicaid managed care program. In CCC Plus, you get:
Behavioral (mental) health services
All in one health plan! To learn more, go to Learn.
How is the CCC Plus Program different from the CCC Program?
The CCC Plus Medicaid Program is different from the CCC Medicare and Medicaid Program in these ways. CCC Plus:
- Is available statewide in six regions
- Is a required program
- Includes adults and children with disabilities
Can I opt out of the CCC Plus Program?
No. You cannot choose to opt out of the CCC Plus Program. CCC Plus is a required program for people who qualify. To learn more, call us at 1-844-374-9159 or TTY: 1-800-817-6608.
What is a health plan?
A health plan is a group of doctors, hospitals, clinics and other health care providers. They work together to meet your health care needs.
Can I change my health plan?
Yes. You can change your health plan in the first 90 days after you become a CCC Plus member. After 90 days, you can change your plan during open enrollment October 1st – December 18th. At other times, you can change plans if you get approval from the Department of Medical Assistance Services. To learn more, call us at 1-844-374-9159 (1-800-817-6608).
What is a primary care provider (PCP)?
Your PCP is the doctor, clinic or other health provider you choose to manage your health care. Your PCP will get to know you and your health care needs. Your PCP will see you when you are sick or need a checkup and refer you to specialists when you need them.
Can a doctor I see now become my PCP?
Yes, if your current primary care provider works with one of the health plans in your county. To find out which health plans your doctor works with, go to Find a provider.
Can I see my current doctor or health provider?
If you have Medicaid
If Medicaid is your only health coverage, you will need to choose a provider in your CCC Plus health plan network. If you want the provider you have now to join the network, talk to your provider and your health plan Care Coordinator.
If you have Medicare
Your CCC Plus Health Plan does not require the Medicare provider to be in network or to get service authorization for Medicare covered services. Check with your Medicare provider to see if they are willing to accept payment from the CCC Plus health plan for the Medicaid covered portion of your copays and deductibles. Take all of your CCC Plus Medicaid and Medicare and other insurance cards to your health care appointments.
If you have other insurance
If you have other insurance the provider will need to be in the CCC Plus network. Or the provider will need to have an agreement with your CCC Plus health plan. The CCC Plus health plan will then pay for remaining costs for covered services. Take all of your CCC Plus Medicaid and other insurance cards to your health care appointments.
What if my current provider does not join my CCC Plus health plan?
You can keep seeing your current providers for the continuity of care period. Before April 1, 2018, that period is up to 90 days from your CCC Plus coverage start date. From April 1, 2018 on, the continuity of care period is up to 30 days from when your CCC Plus coverage began. Check with your provider to see if they are willing to accept payment from the CCC Plus health plan. For help finding a participating provider, call your health plan Care Coordinator.
How does CCC Plus affect my Medicare?
CCC Plus is a Medicaid program. It does not affect your Medicare coverage. You can keep your current Medicare plan. Or you can enroll in a Dual Special Needs Plan. This Medicare Advantage plan covers Part A (hospital insurance), Part B (medical insurance) and Part D (prescription drug coverage). The plan also coordinates your Medicare and Medicaid benefits.
To learn more about which Medicare health plan is right for you, call the free Virginia Insurance Counseling and Assistance Program (VICAP) at 1-800-552-3402. You can also call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). Or visit www.medicare.gov/find-a-plan. You can also look in the handbook mailed to you each fall, Medicare & You.
If you have Medicare, check with your Medicare providers to see if you can keep seeing them. Tell your Medicare provider that the CCC Plus health plan will pay for your Medicare co-pays and deductibles. This is true even if the provider is not in your CCC Plus health plan network or have a CCC Plus service authorization.
Unless you are in the Medicare Extra Help program, you will still pay Part D co-pays for prescription drugs. You will also pay your patient pay amount for long-term services and supports as determined by your local Department of Social Services (DSS) office.
What if the pharmacy will not fill my prescription?
If you have Medicaid only, call your health plan Care Coordinator. If have Medicaid and Medicare, call 1-800-MEDICARE (1-800-633-4227) for questions about drug co-pays or filling prescriptions.
Who can help with a bill I received from my doctor for a Medicaid service?
For questions about bills for a Medicaid service, call your health plan Care Coordinator.